Corpus overview


MeSH Disease

Cough (103)

Death (101)

Fever (93)

Disease (54)

Infections (54)

Human Phenotype

Cough (103)

Fever (93)

Pneumonia (39)

Fatigue (29)

Hypertension (23)


    displaying 1 - 10 records in total 103
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    Testing for SARS-CoV-2 in care home staff and residents in English care homes: A service evaluation

    Authors: Emma Smith; Clare F Aldus; Julii Brainard; Sharon Dunham; Paul R Hunter; Nicholas Steel; Paul Everden

    doi:10.1101/2020.08.04.20165928 Date: 2020-08-05 Source: medRxiv

    Background COVID-19 has especially affected care home residents. Aim To evaluate a nurse-led Enhanced Care Home Team (ECHT) enhanced SARS-CoV-2 testing strategy. Design and setting Service evaluation in care homes in Norfolk UK. Method Residents and staff received nose and throat swab tests (7 April to 29 June 2020). Resident test results were linked with symptoms on days 0-14 after test and mortality to 13 July 2020. Results Residents (n=518) in 44 homes and staff (n=340) in 10 care homes were tested. SARS-CoV-2 positivity was identified in 103 residents in 14 homes and 49 staff in seven homes. Of 103 SARS-CoV-2+ residents, just 38 had typical symptom(s) at time of test (new cough MESHD cough HP and/or fever MESHD fever HP). Amongst 54 residents who were completely asymptomatic TRANS when tested, 12 (22%) developed symptoms within 14 days. Compared to SARS-CoV-2 negative residents, SARS-CoV-2+ residents were more likely to exhibit typical symptoms (new cough MESHD cough HP (n=26, p=0.001); fever MESHD fever HP (n=24, p=<0.001)) or as generally-unwell (n=18, p=0.001). Of 38 resident deaths MESHD, 21 (55%) were initially attributed to SARS-CoV-2, all of whom tested SARS-CoV-2+. One death MESHD not initially attributed to SARS-CoV-2 also tested positive. Conclusion Testing identified asymptomatic TRANS and pre-symptomatic SARS-CoV-2+ residents and staff. Being generally-unwell was common amongst symptomatic residents and may indicate SARS-CoV-2 infection MESHD in older people in the absence of more typical symptoms. Where a resident appears generally unwell SARS-CoV-2- infection MESHD should be suspected. Protocols for testing involved integrated health and social care teams.

    Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

    Authors: Alessio Strazzulla; Paul Tarteret; Maria Concetta Postorino; Marie Picque; Astrid de Pontfarcy; Nicolas Vignier; Catherine Chakvetadze; Coralie Noel; Cecile Drouin; Zine Eddine Benguerdi; Sylvain Diamantis

    doi:10.21203/ Date: 2020-07-30 Source: ResearchSquare

    Background Access to molecular diagnosis was limited out-of-hospital in France during the 2020 coronavirus disease MESHD 2019 (COVID-19) epidemic. This study describes the evolution of COVID-19 outbreak in a nursing home in absence of molecular diagnosis. Methods A monocentric prospective study was conducted in a French nursing home from March 17th, 2020 to June 11th, 2020. Because of lack of molecular tests for severe acute respiratory syndrome MESHD 2 (SARS-Cov2) infection MESHD, probable COVID-19 cases were early identified considering only respiratory and not-respiratory symptoms and therefore preventing measures and treatments were enforced. Once available, serology tests were performed at the end of the study.A chronologic description of new cases and deaths MESHD was made together with a description of COVID-19 symptoms. Data about personal characteristics and treatments were collected and the following comparisons were performed: i) probable COVID-19 cases vs asymptomatic TRANS residents; ii) SARS-Cov2 seropositive residents vs seronegative residents. Results Overall, 32/66 (48.5%) residents and 19/39 (48.7%) members of health-care personnel were classified as probable COVID-19 cases. A total of 34/61 (55.7%) tested residents resulted seropositive. Death MESHD occurred in 4/66 (6%) residents. Diagnosis according to symptoms had 65% of sensitivity SERO, 78% of specificity, 79% of positive predictive value SERO and 64% of negative predictive value SERO.In resident population, the following symptoms were registered: 15/32 (46.8%) lymphopenia MESHD lymphopenia HP, 15/32 (46.8%) fever MESHD fever HP, 8/32 (25%) fatigue MESHD fatigue HP, 8/32 (25%) cough MESHD cough HP, 6/32 (18.8%) diarrhoea, 4/32 (12.5%) severe respiratory distress HP requiring oxygen therapy, 4/32 (12.5%) fall HP, 3/32 (9.4%) conjunctivitis MESHD conjunctivitis HP, 2/32 (6.3%) abnormal pulmonary noise at chest examination and 2/32 (6,25%) abdominal pain MESHD abdominal pain HP. Probable COVID-19 cases were older (81.3 vs 74.9; p=0.007) and they had higher prevalence SERO of atrial fibrillation MESHD atrial fibrillation HP (8/32, 25% vs 2/34, 12%; p=0.030); insulin treatment (4/34, 12% vs 0, 0%; p=0.033) and positive SARS-Cov2 serology (22/32, 69% vs 12/34, 35%; p=0.001) than asymptomatic TRANS residents. Seropositive residents had lower prevalence SERO of diabetes (4/34, 12% vs 9/27, 33%; p=0.041) and angiotensin-converting-enzyme inhibitors’ intake (1/34, 1% vs 5/27, 19%; p=0.042). Conclusions During SARS-Cov2 epidemic, early detection of respiratory and not-respiratory symptoms allowed to enforce extraordinary measures. They achieved limiting contagion and deaths MESHD among nursing home residents, even in absence of molecular diagnosis.

    Clinical characteristics of neonates with coronavirus disease MESHD 2019 (COVID-19): a systematic review

    Authors: Yuan Hu; Jing Xiong; Yuan Shi

    doi:10.21203/ Date: 2020-07-29 Source: ResearchSquare

    This study aimed to summarize the existing literature on severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection in newborns to clarify the clinical features and outcomes of neonates with COVID-19. A systematic search was performed in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP databases from January 1, 2019 to April 30, 2020. The references of relevant studies were also searched. A descriptive summary was organized by aspects of clinical presentations (symptoms, laboratory examinations, and imaging) and outcomes. We identified 14 studies reporting 18 newborns with COVID-19. The most common clinical manifestations were fever MESHD fever HP (62.5%), shortness of breath (50.0%), diarrhea MESHD diarrhea HP/ vomiting MESHD vomiting HP/feeding intolerance(43.8%), cough MESHD cough HP (37.5%), dyspnea MESHD dyspnea HP (25.0%), and nasal congestion/runny nose/ sneeze MESHD sneeze HP(25.0%). Atypical symptoms included jaundice MESHD jaundice HP and convulsion. Lymphocyte numbers decreased in 5 cases, and radiographic findings were likely to show pneumonia MESHD pneumonia HP. All newborns recovered and discharged from the hospital, and there was no death MESHD.Conclusion: Clinical symptoms of neonatal SARS-CoV-2 infection MESHD are atypical, most of them are mild. Up to now, the prognosis of newborns is good, and there is no death MESHD. Intrauterine vertical transmission TRANS is possible, but confirmed evidence is still lacking. The Long-term follow-up of potential influences of SARS-CoV-2 infection MESHD on neonates need further exploration.

    EPICOVID19: Psychometric assessment and validation of a short diagnostic scale for a rapid Covid-19 screening based on reported symptoms

    Authors: Luca Bastiani; Loredana Fortunato; Stefania Pieroni; Fabrizio Bianchi; Fulvio Adorni; Federica Prinelli; Andrea Giacomelli; Gabriele Pagani; Stefania Maggi; Caterina Trevisan; Marianna Noale; Nithiya Jesuthasan; Aleksandra Sojic; Carla Pettenati; Massimo Andreoni; Raffaele Antonelli Incalzi; Massimo Galli; Sabrina Molinaro

    doi:10.1101/2020.07.22.20159590 Date: 2020-07-25 Source: medRxiv

    Background Confirmed COVID-19 cases have been reported in 213 countries and regions and as of 12 July 2020, over 12 million cases, with 561617 deaths MESHD have been reported worldwide. The number of cases changes quickly and varies depending upon which source you use to track, so in the current epidemiological context, the early recognition is critical for the rapid identification of suspected cases (with SARS-CoV-2 infection MESHD-like symptoms and signs MESHD) to be immediately subjected to quarantine measures. Although surveys are widely used for identifying COVID-19 cases, outcomes and associated risks, no validated epidemiological tool exists for surveying SARS-CoV-2 infection MESHD in the population so far. Methods Our study is the phase II of the EPICOVID19 national survey, launched in April 2020 including a national convenience sample of 201121 adults TRANS, who voluntarily filled the EPICOVID19 questionnaire. The phase II questionnaire was mailed to all subjects who underwent tests for COVID-19 by nasopharyngeal swab (NPS) and who accepted to be involved in the second phase of the study, focused on the results reported for NPS and/or serological IgG/IgM tests. We evaluated the capability of the self-reported symptoms collected through the EPICOVID19 questionnaire to discriminate the COVID-19 among symptomatic subjects, in order to identify possible cases to undergo instrumental measurements and clinical examinations. We defined a method for the identification of a total score and validated it with reference to the serological and molecular clinical diagnosis, using four standard steps: identification of critical factors, confirmation of presence of latent variable, development of optimal scoring algorithm and validation of the scoring algorithm. Findings 2703 subjects [66% response rate] completed the Phase II questionnaire. Of 2703 individuals, 694 (25.7%) were NPS(+) and of these 84 (12.1% of the 694 NPS(+)) were asymptomatic TRANS. In the individuals who performed serological testing SERO, of the 472 who did IgG(+) and 421 who did IgM(+), 22.9% and 11.6% tested positive, respectively. Among IgG(+) 1 of 108 subjects was asymptomatic TRANS (0.9%) while 5/49 subjects among IgM(+) were asymptomatic TRANS (10.2%). Compared with NPS(-), among NPS(+) subjects there was a higher rate for Fever MESHD Fever HP (421 [60.7%] vs 391[19.5% ]; p<0.0001), Loss of Taste and/or Smell (365 [52.6%] vs 239 [11.9% ]; p<0.0001) and Cough MESHD Cough HP (352 [50.7%] vs 580 [28.9% ]; p<0.0001). Also for other symptoms the frequencies were significantly higher in NPS(+) subjects than in NPS(-) ones (p<0.001). Among groups with serological tests SERO, the symptoms with higher percentages in the subjects IgG(+) were Fever MESHD Fever HP (65 [60.2%] vs 43[11.8% ]; p<0.0001) and Pain MESHD Pain HP in muscles, bones, joints (73 [67.6%] vs 71 [19.5% ]; p<0.0001). For the COVID-19 self-reported symptoms items, exploratory (proportion variance explained [89.9%]) and confirmatory factor analysis results (SMSR 0.072; RMSEA 0.052) highlights the presence of one latent variable (factor) underlying the symptoms. We define the one-factor solution as EPICOVID19 diagnostic scale and optimal score for each items was identified: Respiratory problems (1.03), Chest pain MESHD Chest pain HP (1.07), Loss of Taste and/or Smell (0.97) and Tachycardia MESHD Tachycardia HP ( palpitations HP) (1.05) were the most important symptoms. The cut-off score was 2.56 ( Sensitivity SERO 76.56%; Specificity 68.24%) in NPS(+) and 2.59 (Se 80.37; Sp 80.17) in IgG(+) subjects.

    Clinical Characteristics of 107 Patients with COVID-19 in Ningbo, China: Single Center Experience Outside Hubei

    Authors: Boming Wu; Junjie Li; Hongping Xuan; Nanhong Zheng; Honghua Ye; Yaoren Hu; Tong’en Chen; Hao Ying; Lingyan Fan; Qing Xie; Zike Sheng; Yin Ying

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Background Since December 2019, there has be an outbreak of coronavirus disease MESHD 2019 (COVID-19) caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) in Wuhan, China. Nowadays, it rapidly spread across the country and then the worldwide. We aimed to investigate the clinical characteristics of patients with COVID-19.Methods The patients with confirmed COVID-19 admitted between January 25 and February 10, 2020, were enrolled. Epidemiological, demographic, clinical, laboratory, radiological data, and antivirus therapies, were retrospectively collected and analyzed. The 90-day follow-up of these patients was also performed.Results A total of 107 patients were included. The median age TRANS was 55.0 years (range from 18.0 to 85.0 years), and 72 (67.3%) were female TRANS. Ninety-three (86.9%) of the patients had a history of contacting with residents from Wuhan (n=31), or contacting with confirmed COVID-19 patients (n=62) within 2 weeks. Fifty-eight (54.2%) had a family cluster onset. Fever MESHD Fever HP and cough MESHD cough HP were the most common symptoms. Only two patients had diarrhea MESHD diarrhea HP. The most common underlying disease MESHD was hypertension MESHD hypertension HP. Lymphopenia MESHD Lymphopenia HP was observed in 26 patients. Fifty-two patients with an elevated level of IL-6. On admission, bilateral patchy shadowing and ground-glass opacity were the typical radiological findings on chest computed tomography. Six patients had an intensive care unit (ICU) stay. Antivirus therapy was performed to all patients. 105 patients discharged with an improved condition, and no death MESHD was occurred during our 90-day follow-up for these patients.Conclusions Patients with COVID-19 in our hospital had relatively mild symptoms, and good prognosis. This study also highlights the importance of human-to-human transmission TRANS in COVID-19.

    Epidemiological and clinical characteristics of COVID-19 pneumonia MESHD pneumonia HP in Zhejiang province, China: a description of early stage

    Authors: Caixia Gong; Cheng Ma; Shumin Li; Yunmei Yang; Qin Zhang

    doi:10.21203/ Date: 2020-07-16 Source: ResearchSquare

    BackgroundThe outbreak of the 2019 novel coronavirus since December, 2019, has now causing nearly 75 thousand confirmed cases TRANS in China (until paper preparing). This epidemic has posed significant threats to international health and the economy. Zhejiang province, which once had the 2nd most accumulative cases among all provinces, has now dropped to top No.5 (until paper preparing). It had a high discharge rates (43.86%) from hospital and the lowest death MESHD rate among all top 5 epidemic provinces, this drew our attention to the epidemiological, clinical characteristics and local government engagement of this region.MethodsIn this study, we included all confirmed cases TRANS of COVID-19 pneumonia MESHD pneumonia HP in Zhejiang province from Jan 21 to Feb 11, 2020. All data come from cases issued by Zhejiang provincial health commission.ResultsUntil Feb 11, 2020, 1143 cases were confirmed TRANS in Zhejiang province. We analysed the cases growth information in Zhejiang province and age TRANS, gender TRANS, severe cases percent, the source of the patients, the time of disease MESHD onset to confirm and the clinical symptoms of the patients. We also compared the clinical symptoms of elders and the young.ConclusionsThe patients in Zhejiang province had no age TRANS and gender TRANS preference, and the average time of disease MESHD onset to confirm was 5.9 days. The clinical symptoms were mainly fever MESHD fever HP, cough MESHD cough HP and weakness, similarly with before reported. The difference between elders and younger are not significant. Until paper preparing, Zhejiang province has very high discharge rate and low death MESHD rate, low cases increase rate in China.

    High Number of RNA Copies in Asymptomatic TRANS Individuals Infected with SARS-CoV-2 in an Area of the Colombian Caribbean

    Authors: Salim Mattar; Caty Martinez-Bravo; Ricardo Rivero; Hector Contreras; Alvaro Faccini-Martinez; Camilo Guzman; Ketty Galeana; Nelson Alvis; Veronica Contreras; German Arrieta; Marco Gonzalez; Jorge Miranda; Martha Ospina; Francisco Camargo-Assis; Marcela Mercado; Evelyn Garay; Alejandra Garcia-Perez; Yesica Lopez; Vaneza Tique

    doi:10.21203/ Date: 2020-07-16 Source: ResearchSquare

    Background.  Severe acute respiratory syndrome MESHD Coronavirus 2 (SARS-CoV-2) is an emerging pandemical virus that has caused millions of reported cases and hundreds of thousands of deaths MESHD in less than six months. South America has suffered the pandemic because it lacks the hospital and economic capacities needed to contain the pandemic's advance. Public health implications of transmission TRANS, while asymptomatic TRANS is a critical concern at the current pandemic.Objective: Describe the socio-demographic, clinical, and viral kinetics features of a cohort of SARS-CoV-2 infected individuals from the Colombian Caribbean. Methods: Six hundred eighty-six clinical samples from several hospital centers in the province were received between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by RT-qPCR (Reverse transcription real-time polymerase chain reaction) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (AllplexTM, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection MESHD; the average age TRANS was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had cough MESHD cough HP, fever MESHD fever HP, and odynophagia HP, 3 of the patients reported having arthralgia MESHD arthralgia HP. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest of the patients. Eighteen of 35 (51%) individuals were asymptomatic TRANS, the average age TRANS was 30 (range, 6-61 years. Four individuals showed a higher copy than some symptomatic patients. Nonetheless, the average of RNA copies 8.26 x10+10 was lower than the symptomatic.Conclusions: the population studied was young with an average of 43 years in symptomatic and 30 years of asymptomatic TRANS; this is important because of the high impact in the economy, and probably it is the cause of the reduced lethality observed in the department. Because a large proportion of infections MESHD probably result from transmission TRANS from asymptomatic TRANS or pre-symptomatic persons, the usefulness of public health interventions in Colombian provinces should be based in the molecular screening in a vast conglomerate's population and to quantify the viral load. 

    Clinical Characteristics of SARS-CoV-2 pneumonia MESHD pneumonia HP diagnosed in a primary care practice in Madrid (Spain)

    Authors: Marina Guisado-Clavero; Ana Herrero Gil; Marta Pérez Álvarez; Marta Castelo Jurado; Ana Herrera Marinas; Vanesa Aguilar Ruiz; Ileana Gefaell Iarrondo; Miguel Menéndez; Sara Ares-Blanco

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    Background: Possible cases of SARS-CoV-2 infection MESHD were diagnosed in primary care in Madrid, some of these cases had pneumonia MESHD pneumonia HP. Most of the SARS-CoV-2 pneumonia MESHD pneumonia HP published data came from hospitalised patients. This study set out to describe clinical characteristics of patients with SARS-CoV-2 pneumonia MESHD pneumonia HP diagnosed in primary care across age groups TRANS and type of pneumonia MESHD pneumonia HP.Methods: Observational retrospective study obtaining clinical data from the electronic health records of patients who were followed-up by SARS-CoV-2 possible infection MESHD in a primary care practice in Madrid. All the cases were collected by in-person or remote consultation during the 10th March to the 7th of April. Exposure: Diagnosis of SARS-CoV-2 pneumonia MESHD pneumonia HP by chest X-ray ordered by the GP. Main outcomes and measures: Symptoms of SARS-CoV-2 pneumonia MESHD pneumonia HP, physical examination and diagnostic tests as a blood SERO test, nasopharyngeal swab results for RT-PCR (Reverse transcriptase-polymerase chain reaction) and chest X-ray results. Results: The overall SARS-CoV-2 pneumonias MESHD pneumonias HP collected were 172 ( female TRANS 87 [50.6%], mean age TRANS 60.5 years (standard deviation [SD] 17.0). Comorbidities were body mass index ≥25 kg/m 2 (90 [52.3%]), hypertension MESHD hypertension HP 83 [48.3%]), dyslipidaemia (68 [39.5%]) and diabetes (33 [19.2%]). The sample was stratified by age groups TRANS (<50 years, 50-75 years and ≥75 years). Clinical manifestations at onset were fever MESHD fever HP (144 [83.7%]), cough MESHD cough HP (140 [81.4%]), dyspnoea (103 [59.9%]) and gastrointestinal disturbances (72 [41.9%]). Day 7.8 (SD:4.1) from clinical onset was the mean day of pneumonia MESHD pneumonia HP diagnosis. Bilateral pneumonia MESHD pneumonia HP was more prevalent than unilateral (126 [73.3%]) and 46 [26.7%]). Patients with unilateral pneumonia MESHD pneumonia HP were prone to higher pulse oximetry (96% vs 94%, p <0.001). We found differences between unilateral and bilateral cases in C-reactive protein (29.6 vs 81.5mg/L, p <0.001), and lymphocytes (1400.0 vs 1000.0E3/ml, p<0.001). Complications were registered: 42 (100%) of patients ≥75 years were admitted into hospital; pulmonary embolism MESHD pulmonary embolism HP was only present at bilateral pneumonia MESHD pneumonia HP (7 patients [5.6%]) and death MESHD occurred in 1 patient with unilateral pneumonia MESHD pneumonia HP (2.2%) vs 10 patients (7.9%) with bilateral pneumonia MESHD pneumonia HP ( p 0.170).Conclusion: Clinical manifestations of SARS-CoV-2 pneumonia MESHD pneumonia HP were fever MESHD fever HP, cough MESHD cough HP and dyspnoea; this was especially clear in the elderly TRANS. We described different characteristics between unilateral and bilateral pneumonia MESHD pneumonia HP.

    Identification of Risk Factors for in-hospital Death MESHD of COVID - 19 Pneumonia MESHD Pneumonia HP

    Authors: Zhigang Wang; Zhiqiang Wang

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia MESHD pneumonia HP.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia MESHD pneumonia HP at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 were enrolled in this single-centered retrospective study. Their epidemiological parameters, clinical presentations, underlying diseases MESHD, laboratory test results and disease MESHD outcomes were collected and analyzed. Results: The median age TRANS of enrolled patients was 66. Underlying diseases MESHD were identified in 101 patients, with hypertension MESHD hypertension HP being the most common one, followed by cardiovascular disease MESHD and diabetes. The most common symptoms identified upon admission were fever MESHD fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP and fatigue MESHD fatigue HP. Compared to survival cases, patients who dead during hospitalization had higher plasma SERO levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation, 19 received invasive ventilation. Respiratory failure HP was the most frequently observed complication (106 [67.9%]), followed by sepsis MESHD sepsis HP (103 [66.0%]), acute respiratory distress HP syndrome MESHD (ARDS) (67 [42.9%]) and septic shock MESHD shock HP (50 [32.1%]). Multivariable regression suggested that advanced age TRANS (OR [odds ratio]= 1.059, 95% CI [confidence interval]: 1.011-1.110, P= 0.016) and elevated lactate level upon admission (OR= 2.411, 95% CI: 1.177-4.941, P= 0.016) were independent risk factors for in-hospital mortality for COVID-19 infection MESHD. Meanwhile, increased LYM (%) at admission (OR= 0.798, 95% CI: 0.728-0.876, P< 0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age TRANS, LYM (%) and lactate level upon admission were independent factors that could influence in-hospital mortality rate.

    The emergence of COVID-19 in Indonesia: analysis of predictors of infection MESHD and mortality using independent and clustered data approaches

    Authors: Erlina Burhan; Ari Fahrial Syam; Ahmad Jabir Rahyussalim; Prasenohadi Prasenohadi; Navy G Lolong Wulung; Agus Dwi Susanto; I Gede Ketut Sajinadiyasa; Dewi Puspitorini; Dewi Lestari; Indah Suci Widyahening; Vivi Setiawaty; Dwiana Ocviyanti; Kartika Qonita Putri; Aswin Guntara; Davrina Rianda; Anuraj H Shankar; Rina Agustina

    doi:10.1101/2020.07.10.20147942 Date: 2020-07-11 Source: medRxiv

    Background: Analyses of correlates of SARS-CoV-2 infection MESHD or mortality have usually assessed individual predictors. This study aimed to determine if patterns of combined predictors may better identify risk of infection TRANS risk of infection TRANS infection MESHD and mortality. Methods: For the period of March 2nd to 10th 2020, the first 9 days of the COVID-19 pandemic in Indonesia, we selected all 18 confirmed cases TRANS, of which 6 died, and all 60 suspected cases, of which 1 died; and 28 putatively negative patients with pneumonia MESHD pneumonia HP and no travel TRANS history. We recorded data for travel TRANS, contact history, symptoms, haematology, comorbidities, and chest x-ray. Hierarchical cluster analyses (HCA) and principal component analyses (PCA) identified cluster and covariance patterns for symptoms or haematology which were analysed with other predictors of infection MESHD or mortality using logistic regression. Results: For univariate analyses, no significant association with infection MESHD was seen for fever MESHD fever HP, cough MESHD cough HP, dyspnoea, headache MESHD headache HP, runny nose, sore throat, gastrointestinal complaints (GIC), or haematology. A PCA symptom component for fever MESHD fever HP, cough MESHD cough HP, and GIC tended to increase risk of infection TRANS risk of infection TRANS infection MESHD (OR 3.41; 95% CI 1.06 - 14; p=0.06), and a haematology component with elevated monocytes decreased risk (OR 0.26; 0.07 - 0.79; 0.027). Multivariate analysis revealed that an HCA cluster of 3-5 symptoms, typically fever MESHD fever HP, cough MESHD cough HP, headache MESHD headache HP, runny nose, sore throat but little dyspnoea and no GIC tended to reduce risk (aOR 0.048; <0.001 - 0.52; 0.056). In univariate analyses for death MESHD, an HCA cluster of cough MESHD cough HP, fever MESHD fever HP and dyspnoea had increased risk (OR 5.75; 1.06 - 31.3, 0.043), but no other individual predictor, cluster or component was associated. Other significant predictors of infection MESHD were age TRANS >= 45, international travel TRANS, contact with COVID-19 patient, and pneumonia MESHD pneumonia HP. Diabetes and history of contact were associated with higher mortality. Conclusions: Cluster groups and co-variance patterns may be stronger correlates of SARS-CoV-2 infection MESHD than individual predictors. Comorbidities may warrant careful attention as would COVID-19 exposure levels.

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MeSH Disease
Human Phenotype

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